Segments in this Video

Manual Therapy Techniques: Theory and Evidence(02:16)

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Dr. Regis Turocy will look at a broad range of manual therapy skills, their intended function, and their pitfalls. He discusses the importance of touch in the healing process; see a visual representation of the somatosensory cortex.

Manual Therapy(02:57)

Manual therapy is used to alter pain, joint motion, and adaptively shortened tissue. Dr. Turocy provides a brief history of 20th century system developments, including an ongoing neurobiological revolution. Approaches are tissue specific; technique variety can be a problem.

Manual Therapy Challenges(02:44)

There is little agreement about which technique is best. Decisions are based on training, biases, and deductive reasoning. Outcome measures and efficacy are unknown. Variables include: joint knowledge, symptoms, patient and provider position, hand placement, specificity and force direction.

Augmented Soft Tissue Mobilization(01:14)

ASTM uses hand held devices to assist with mobilization of disorganized connective tissue. It creates microvascular trauma, capillary hemorrhage, and localized inflammatory response, and stimulates a healing cascade. Challenges are similar to those of transverse friction massage.

Myofascial Release(03:03)

The technique is based on the belief that trauma causes a loss of physiological adaptive capabilities and pulls the body out of alignment; it also draws upon holistic theory. Challenges include: relying on perceived patient tissue feedback, measuring pressure, and palpation skills.

Kaltenborn (Norwegian Approach)(02:31)

Following a concave-convex rule, the technique uses traction and accessory movements to reduce pain and increase mobility. Pressure is classified in three grades, which are hard to measure. Other challenges include: hand placement, technique, patient and practitioner position, and strength and duration.

Maitland (Australian Approach)(01:41)

The technique employs five grades of oscillatory mobilization to restore normal joint function; it is difficult to quantify touch amplitudes. Further challenges include: technique, methodology, hand placement, and positioning.

Description

This video presents an overview of the concepts and principles underlying several common manual-therapy techniques, including touch, soft-tissue, joint mobilization, and neurodynamic mobilization. It discusses the clinical application of each technique, presents current evidence to support each technique, and explores what the future holds for manual-therapy techniques.